腹腔镜肾切除术时腹膜后CO_2气腹对呼吸循环功能的影响

The Effect of Respiration and Circulation to use the CO_2-pheuno Peitoneum in Laparoscopin Nephrectomy

目的：观察腹腔镜肾切除术麻醉期间腹膜后间隙CO2气腹对呼吸循环的影响。方法：择期手术全麻患者15例，ASAⅠ～Ⅱ级，静脉谤导后作气管内插管，机控呼吸，并维持潮气量8ml／kg，监测MAP、ECG、CVP、VT、PEAK、SPO2、PetCO2和动脉血气分析。分别在控制呼吸5min、气腹前、气腹后10、30和60mln时记录各项监测数据。结果：充气前后SPO2和PaO2均无明显变化（P〉0．05），VT减幅不大，PEAK轻微升高（P〉0．05），HR和MAP无明显变化（P〉0．05），CVP明显升高（P〈0．01）。PetCO2和PaCO2升高（P〈0．01），PH值下降但仍在正常范围（P〈0.01）。结论：全麻下机控呼吸时，腹膜后CO2充气对呼吸循环功能影响较轻，维持足够的通气量可避免因CO2经后腹膜吸收造成的高碳酸血症。

Objective： To observe the effect of respiration and circulation to use the CO2 - Pheunoperitoneum in retropiritoneal space during the anesthesia in laparoscopin nephrectomy. Method： To choose the patients of general anesthesia 15 in a lot, ASA Ⅰ -Ⅱ, induction of anesthesia to endotracheal intubation, breathing by respirator, keeping tidal volume on 8 ml/kg , monitoring the MAP, ECG, CVP, VT, PEAK, SPO2, PetCO2 arterial blood gas analysis in 5,10,30 and 60 minutes. Result： To compare filling gas with no gas , no difference between SPO2 and PaO2 （ P 〉 0.05 ）, no obiously change in VT and PEAK （ P 〉 0.05 ）. So does in HR and MAP （ P 〉 0.05 ）, CVP, PetCO2 and PaCO2 inproving obviously （ P 〈 0.01 ）. Conclusion： To fill gas （ CO2 ） in retroperitoneal space during general anesthesia, there is little influence to the respiration and circulation. Keeping enough ventilatorv. Capacity can avoud the hypercaonia in restrooeritoneal soace.